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Friends Don't Let Best Friends Die
Memorial Gift

Make checks payable to:

National Greyhound Foundation, Inc.
P.O. Box 638
Homosassa, FL 34487
1-352-628-2281
Fax: 352-628-9497

Instructions: Print out this form, fill it out, and then Fax or Mail it to us.

Name _______________________________________________________
Address _______________________________________________________
City _______________________ State ______ Zip Code _____________
Telephone ______________________ Email ____________________________

_____________ Gift Amount

We will send the recipient of your gift a Greyhound Memorial Card with your personalized message within a few days.

Personalized Message:

__________________________________________________________

__________________________________________________________

__________________________________________________________

__________________________________________________________

__________________________________________________________

Please Select A Method of Payment Below.

Check:

___ Please transfer monthly gifts from my credit card:

____ Visa ____ Amex ____ Discover ____ Mastercard
Account Number ________________________________________________
Expiration Date ________________________________________________
Signature ________________________________________________

Check:

___ I have enclosed a check for my Memorial Gift.

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